| Ms Mary Clare Nordahl, CRNA | |
|
711 W Adams St, Black River Falls, WI 54615-9108 | |
| (715) 284-5361 | |
| (715) 284-7166 |
| Full Name | Ms Mary Clare Nordahl |
|---|---|
| Gender | Female |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 711 W Adams St, Black River Falls, Wisconsin |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447270681 | NPI | - | NPPES |
| 71871 | Other | WI | RN LICENSE |
| 37187 | Other | AANA REGISTRATION | |
| 1224 | Other | WI | APNP REGISTRATION |
| 0002 | Other | WI | SEQUENCE NUMBER |
| 43352400 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 71871 (Wisconsin) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Mary Clare Nordahl, CRNA 1212 Harrison St, Black River Falls, WI 54615-1906 Ph: (715) 284-9691 | Ms Mary Clare Nordahl, CRNA 711 W Adams St, Black River Falls, WI 54615-9108 Ph: (715) 284-5361 |
Mr. James Earl Carroll, CRNA, APNP Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 711 W Adams St, C/o Anesthesia Department, Black River Falls, WI 54615 Phone: 715-284-5361 Fax: 715-284-7166 | |
Edward Zhovtis, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 711 W Adams St, Black River Falls, WI 54615 Phone: 715-284-5361 Fax: 715-284-3684 |